HealthCare.gov’s Back-Office Problems Move Front and Center

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What counts in a sale isn’t so much the pitch, but the closing of the deal. Without an order and check in hand, the transaction isn't complete.

HealthCare.gov – and all of the state exchanges for that matter – have made a great pitch, although it seems that the federal site and states dependent upon it have yet to fully execute their transactions.

Through November, about 2 million Americans made it through the application process on the exchanges. But will they be able to choose the right plan and actually get insurance? The jury's still out.

Yet were the nuts and bolts of e-commerce discussed when President Obama met with executives from Apple, Facebook, Google and Twitter on Tuesday? Although it seems that meeting with these tech titans is a tad late for the botched rollout of the HealthCare.gov insurance marketplace, perhaps they can lend some needed support. If HealthCare.gov was executed as well as most ecommerce sites, it would have the seamless transactions of Apple's iTunes store, accounts that are as easy to set up as a Facebook page with the search capability of Google.

Obviously, that hasn’t happened. My tortured experience with the federal government's site suggests that the exchanges may have some serious back-office issues that affected the part of the transaction that stores your application, enters it into the system and allows you to select a policy – and then pay for it online.

When I applied for insurance back in October, I couldn't even enter the HealthCare.gov website. Although the system now recognizes my name and allows me to log in, I can't locate my application nor pick a plan. I get stuck at a screen that suggests I haven't "verified" my identity.

Although I spent several hours "talking" my application to a HealthCare.gov representative on a toll-free hotline – divulging my entire family's Social Security numbers and dates of birth – when I called three weeks ago, they said they had no record of my application and asked me to send a photocopy of my driver's license to a government processing center in London, Kentucky.

When I called back last week, I spent another half hour on the phone with HealthCare.gov. After the first representative placed me on hold and eventually hung up, I called back and asked for the supervisor.

"Is my application file in your system?" I asked.

"We don't have any answers," the supervisor replied. "It takes two weeks to do identity proofing. You'll get a reply by mail or a pre-recorded phone message."

"What about the person who called two weeks ago, claiming they were from a government processing center in Arkansas?"

"We don't have actual people calling. We would have a pre-recorded message, not a human being."

"Oh, so that was a scam?"

"I can't tell you that."

"So, can I get into the HealthCare.gov site and still apply?"

"Not without identity verification."

Kafka has nothing on these folks. Unless I want to go through another "talked-in" application over the phone, I will have to wait for the government to work through its convoluted back-office technical mess, if they do it at all.

How the Real World WorksMost insurance and e-commerce companies have nailed these transactions. You fill out a web-based form, it verifies your credit card information and you have an emailed confirmation of your order within minutes, if not seconds.

If identity and credit card information only takes seconds on most e-commerce sites, why is HealthCare.gov so lame? There are tens of thousands of these sites that do transactions every second of the day.

As the news improves regarding access to the federal site, I wonder how many other people are going through what I have been. And I openly question how the Department of Health and Human Services is getting applications to insurers to set up payment. Are insurers actually getting these files?

Through November, nearly 400,000 Americans selected plans through the health insurance marketplace. Although the demand for the exchanges is clearly high – with strong numbers for working sites in California and New York – it remains to be seen if HHS can follow through and actually issue policies.

The Department of Health and Human Services said Saturday that it continues to focus its attention on these back-end issues. It announced that, since the beginning of December, the rate of transaction forms with missing or garbled data “has been close to zero.”

Yet the government said that it had failed to transmit proper data for nearly 15,000 people who enrolled between Oct. 1 and Dec. 5.

The way things are going, I doubt if I will have a policy in place before Christmas.

Journalist and speaker John F. Wasik has written 14 books on subjects that range from wealth to ecology to retirement. He writes for Reuters and contributes to Forbes, The New York Times and other publications.